The Best Ways To Quit

For long-time smokers, particularly those who puff 20 or more
cigarettes a day, quitting isn’t easy. Studies have demonstrated that it
may take several tries before many smokers are able to finally quit.
Stress, habit and cigarette cravings are common reasons for people to
resume smoking.

Even though many smokers quit cold turkey without the help of
programs or prescriptions, the success rate is only about 5 percent per
attempt, which is lower than for assisted quitting methods. If you are a
heavy smoker — smoking more than one pack per day or needing to light a
cigarette within 30 minutes of waking up in the morning — you may have a
more difficult time quitting and should consider trying the more
effective methods. Research shows that these methods increase the rate
of success in smoking cessation:

Nicotine replacement with counseling. Nicotine
replacement allows your first weeks or months without cigarettes to be a
time with fewer symptoms from nicotine withdrawal than you would
otherwise have. The success rate for most counseling plus nicotine
replacement programs is about 20 percent but can range up to 40 percent
at some of the best university-based smoking-cessation programs.
Nicotine replacement can be as simple as wearing the patch or chewing
nicotine-containing gum, both of which are available over the counter.
There is also a nicotine nasal spray or an inhaler that give heavy
smokers a faster and higher dose of nicotine, which could more closely
simulate smoking. Some smokers may find these newer methods more
effective.

Smoking-cessation programs. If you’re looking for
counseling, try local hospitals, health plans, your employer, the
American Cancer Society or other health associations. To increase your
odds of success, many experts recommend that you select a program that
is at least four to eight weeks in length. The programs that work best
provide plenty of encouragement and weekly one-on-one meetings with a
counselor. The programs should also teach ways to cope with stress and
other situations that might lead to a relapse. Free counseling is
available in many states in the form of a telephone hotline for
quitters. Your doctor can help you to identify a tobacco “quit line” if
one is available.

Nicotine replacement alone. In the absence of counseling, nicotine replacement doubles the normal cold turkey success rate to about 10 percent.
Though this is not as good as the 20- to 40-percent success rates that
can be obtained with behavioral and nicotine-replacement therapy, it’s
better than the estimated 5-percent success rate of attempting to quit
cold turkey.

Prescription medications.

Antidepressants. The prescription drug Zyban (bupropion),
which aids in the control of cravings for nicotine, is another effective
therapy to help smokers quit. Studies have shown that smokers who took
Zyban as well as nicotine replacement therapy had double the success
rate in quitting — 20 percent or more — when compared with those who
received only the nicotine-replacement therapy. In addition, people who
take Zyban gain less weight than those who quit with other methods.
Although this drug originally was developed as an antidepressant, it
works well even in smokers who are not depressed. Another antidepressant
medicine, nortriptyline (Aventyl, Pamelor, or generic nortriptyline)
has been shown to have similar beneficial effects.

Varenicline (Chantix). Varenicline is the first new
anti-smoking drug approved by the US Food and Drug Administration in the
past ten years. This prescription drug acts on nicotine receptors in
the brain to both decrease the craving for nicotine and also to diminish
the intensity of nicotine withdrawal symptoms. The standard dose is one
milligram two times per day for 12 weeks. People often start at
one-half the usual dose and increase the dose after a few days. The quit
rate at one year is three times up to three times higher compared to a
placebo.

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